Scope with integral cleaning element for use during a laparoscopic procedure

ABSTRACT

A scope includes a housing having a distal portion with a distal end. A lens is at the distal end. A cleaning element is operatively coupled to the distal portion of the housing, wherein the cleaning element is movable between a first position and a second position contacting the distal end.

RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application No.62/513,270, filed May 31, 2017, and U.S. Provisional Application No.62/513,278, filed May 31, 2017, each of which is herein incorporated byreference in its entirety. Further, each of the following applications,filed on Mar. 7, 2017, is herein incorporated by reference in itsentirety: U.S. patent application Ser. No. 15/452,169, U.S. patentapplication Ser. No. 15/452,211, and U.S. patent application Ser. No.15/452,246.

FIELD OF TECHNOLOGY

The present disclosure relates generally to scopes, such aslaparoscopes, trocar assemblies, and related devices, and morespecifically, to scopes for use with trocar assemblies, for example,which can be utilized in laparoscopic medical procedures.

BACKGROUND

Laparoscopic surgery is a minimally-invasive surgical techniquetypically performed with the assistance of one or more medicalinstruments inserted through a small incision in a patient's body.Laparoscopic surgery is often preferred to traditional and more invasivesurgical procedures because of the reduced frequency and degree ofcertain postoperative side effects, such as postoperative pain,swelling, internal bleeding, and infection risk. The minimally-invasivenature of laparoscopic procedures may also result in decreased recoverytimes and shorter hospital stays.

Typical medical devices utilized during laparoscopic procedures haveinstruments mounted on an elongated metal or plastic body that areinserted into the patient's body and maneuvered to a target area withina body cavity (e.g., the abdominal, pelvic, thoracic, or chest cavity,where insufflation may be used to provide additional space in which tomaneuver, which requires a fluid-patient barrier to maintaininsufflation pressure in the cavity). One or more trocar assemblies aretypically first inserted into the patient body at an incision site (foreach), and the instruments access the patient body through the trocarassembly(ies).

Often, a medical device including a camera or other image-transmittingdevice is inserted through a trocar to transmit one or more images or alive video feed from within the body cavity to a medical professional(such as the surgeon). The device may be referred to as a scope or alaparoscope, and its transmission may guide the medical professional'sactions during the laparoscopic procedure.

A problem typically experienced during laparoscopic procures involves acompromised image or video feed due to an obstructed lens of thelaparoscope. This obstruction may be caused by condensation (e.g., fog)and/or debris such as bodily fluids or displaced tissue encountered bythe lens during the procedure. Such obstruction is problematic becausethe lens of the laparoscope preferably remains contained in apressurized and sterile environment (e.g., insufflated body cavity), andremoving the lens from that environment for cleaning purposes may causelengthy interruptions prolonging patient anesthesia and increasing arisk of compromised sterility.

SUMMARY

In one aspect, a scope includes a housing having a distal portion with adistal end. A lens is at the distal end. A cleaning element isoperatively coupled to the distal portion of the housing, wherein thecleaning element is movable between a first position and a secondposition contacting the distal end.

In another aspect, a trocar assembly includes a cannula having aproximal portion and an opposing distal portion. The distal portion isconfigured to extend into a patient body. The cannula defines an accesschannel between the proximal portion and the distal portion. A scope ismovably positioned within the access channel. The scope can bemaneuvered through the access channel to a location within the patientbody. A cleaning element is operatively coupled to a distal portion ofthe scope. The cleaning element is configured to contact at least a lensof the scope.

In yet another aspect, a method for cleaning a distal end of a scopeincludes coupling a cleaning element at a distal portion of the scope.The distal portion is configured to extend into a patient body to alocation within the patient body. At least a distal end of the scope iscleaned with the cleaning element by moving the cleaning element withrespect to the distal end of the scope.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a distal portion of an example scope foruse during a laparoscopic procedure, the example scope having a cleaningelement in a first position, in accordance with certain exampleembodiments;

FIG. 2 is a perspective view of the distal portion of the example scopeshown in FIG. 1 with the cleaning element in a second position;

FIG. 3 is a perspective view of a distal portion of an example scope foruse during a laparoscopic procedure before cleaning of the distalportion with an integrated cleaning element, in accordance with certainexample embodiments;

FIG. 4 is a perspective view of the distal portion of the example scopeshown in FIG. 3 as the cleaning element moves across a cover to cleanthe cover;

FIG. 5 is a perspective view of the distal portion of the example scopeshown in FIG. 3 after cleaning of the distal portion with the integratedcleaning element;

FIG. 6 is a perspective view of a distal end of the example scope duringcleaning of the distal portion with the integrated cleaning element;

FIG. 7 is a perspective view of a distal portion of an example scope foruse during a laparoscopic procedure, the example scope including a bandextending laterally across the distal portion with the cleaning elementin a second position, in accordance with certain example embodiments;

FIG. 8 is a sectional view of a portion of the distal portion of theexample scope shown in FIG. 7 with the band contacting an outer surfaceof the lens;

FIG. 9 is a perspective view of the distal portion of the example scopeshown in FIG. 7 with the cleaning element in a first position aftercleaning of the distal portion with the integrated band;

FIG. 10 is a perspective view of a distal end of the example scopeincluding a band extending laterally across the distal portion as theband is advanced;

FIG. 11 is a perspective view of a distal portion of an example scopefor use during a laparoscopic procedure, the example scope including aband extending laterally across the distal portion with the cleaningelement in a second position, in accordance with certain exampleembodiments;

FIG. 12 is a perspective view of a portion of the distal portion of theexample scope shown in FIG. 11 with the cleaning element in a firstposition after cleaning of the distal portion with the integrated band;

FIG. 13 is a sectional view of the distal portion of the example scopeincluding a band extending laterally across the distal portion as theband is advanced;

FIG. 14 is a perspective view of a distal portion of an example scopefor use during a laparoscopic procedure, the example scope including acleaning element having an insert with a film extending laterally acrossthe distal portion with the cleaning element in a second position, inaccordance with certain example embodiments;

FIG. 15 is a plan view of a distal end of the example scope shown inFIG. 14;

FIG. 16 is a perspective view of a film suitable for use with thecleaning element;

FIG. 17 is a perspective view of the distal portion of the example scopeshown in FIG. 14 with the cleaning element in a first position;

FIG. 18 is a perspective view of a distal portion of an example scopefor use during a laparoscopic procedure, the example scope including acleaning element having a film extending laterally across the distalportion with the cleaning element, in accordance with certain exampleembodiments;

FIG. 19 is a perspective view of a film suitable for use with thecleaning element;

FIG. 20 is a sectional view of the distal portion of the example scopeshown in FIG. 18;

FIG. 21 is a perspective view of a distal portion of an example scopefor use during a laparoscopic procedure, the example scope including acleaning element having a film extending laterally across the distalportion with the cleaning element in a second position, in accordancewith certain example embodiments;

FIG. 22 is a sectional view of a distal portion of an example scope witha cleaning element in a second position, in accordance with certainexample embodiments;

FIG. 23 is a sectional view of the distal portion of the example scopeshown in FIG. 22 as the cleaning element moves from the second positionto a first position;

FIG. 24 is a sectional view of the distal portion of the example scopeshown in FIG. 22 as the cleaning element moves from the second positionto the first position;

FIG. 25 is a sectional view of the distal portion of the example scopeshown in FIG. 22 with the cleaning element in the first position;

FIG. 26 is a perspective view of a distal portion of an example scopefor use during a laparoscopic procedure, the example scope including anintegral cleaning element, in accordance with certain exampleembodiments;

FIG. 27 is a plan view of a distal portion of an example scope for useduring a laparoscopic procedure, the example scope including a shield ina second position, in accordance with certain example embodiments;

FIG. 28 is a sectional view of the distal portion of the example scopeshown in FIG. 27 with the shield in a first position;

FIG. 29 is a perspective view of the distal portion of the example scopeshown in FIG. 27 with the shield in the first position; and

FIG. 30 is a perspective view of a distal portion of an example scopefor use during a laparoscopic procedure, in accordance with certainexample embodiments.

DETAILED DESCRIPTION

Various embodiments are described below with reference to the drawingsin which like elements generally are referred to by like numerals. Therelationship and functioning of the various elements of the embodimentsmay better be understood by reference to the following detaileddescription. However, embodiments are not limited to those illustratedin the drawings. It should be understood that the drawings may or maynot be to scale, and in certain instances details may have been omittedthat are not necessary for an understanding of embodiments disclosedherein, such as—for example—conventional fabrication and assembly.

The invention is defined by the claims, may be embodied in manydifferent forms, and should not be construed as limited to theembodiments set forth herein; rather, these embodiments are provided sothat this disclosure will be thorough and complete, and will fullyconvey enabling disclosure to those skilled in the art. As used in thisspecification and the claims, the singular forms “a,” “an,” and “the”include plural referents unless the context clearly dictates otherwise.Reference herein to any industry and/or governmental standards (e.g.,ASTM, ANSI, IEEE, HIPAA, FDA standards) is defined as complying with thecurrently published standards as of the original filing date of thisdisclosure concerning the units, measurements, and testing criteriacommunicated by those standards unless expressly otherwise definedherein.

The terms “proximal” and “distal” are used herein in the common usagesense where they refer respectively to a handle/doctor-end of a deviceor related object and a tool/patient-end of a device or related object.The terms “about,” “substantially,” “generally,” and other terms ofdegree, when used with reference to any volume, dimension, proportion,or other quantitative or qualitative value, are intended to communicatea definite and identifiable value within the standard parameters thatwould be understood by one of skill in the art (equivalent to a medicaldevice engineer with experience in this field), and should beinterpreted to include at least any legal equivalents, minor butfunctionally-insignificant variants, standard manufacturing tolerances,and including at least mathematically significant figures (although notrequired to be as broad as the largest range thereof).

In example embodiments, such as described herein, a trocar assemblyincludes a proximal portion. A cannula extends between the proximalportion and a distal portion of the trocar assembly opposite theproximal portion. The distal portion of the trocar assembly isconfigured to extend into a patient body. The cannula defines or formsan access channel between a first or proximal opening at the proximalportion and a second or distal opening at the distal portion. The accesschannel is configured to receive a scope, e.g., a laparoscope, such thatthe scope can be maneuvered through the access channel to extenddistally from the distal portion of the trocar assembly at a locationwithin the patient body. The scope includes an integral cleaning elementpositioned at or coupled to a distal portion of the scope. The cleaningelement is configured to contact at least a distal end of the scope,e.g., with the cleaning element in a second position, to periodicallyclean at least the distal end of the scope, e.g., a lens of an imagingdevice at the distal end of the scope, to remove condensation (e.g.,fog) and/or debris, such as bodily fluids or displaced tissue, from thelens during the procedure. In certain example embodiments, the cleaningelement is configured to clean an entire distally facing surface of thelens, e.g., by temporarily occluding an opening at or near a distal endof the housing. With the cleaning element contacting the distally facingsurface of the lens a complete cleaning of the entire lens surface canbe accomplished.

In example embodiments, the cleaning element is movable between a firstposition allowing the scope to freely move in a proximal directionand/or a distal direction within the access channel and a second orcleaning position. In the second position, the cleaning element contactsat least the distal portion of the scope to clean desired portions ofthe scope, e.g., the lens. In certain example embodiments, the cleaningelement includes a plurality of members, e.g., a plurality of brushes,bristles, fibers, fingers, leaflets, wipers, pads, projections, or anycombination thereof such that the plurality of members contact thescope. The members may be formed of a compliant or flexible materialsuch that each member is movable upon contacting the scope, e.g., toallow the scope to move through a housing of the scope withoutundesirable contact with or interference from the members, whileproviding sufficient resilience to facilitate cleaning the distal end ofthe scope, e.g., the lens.

Referring to FIGS. 1-30, a scope 40, such as a laparoscope or anothersuitable scope, includes an imaging device, e.g., a lens 42, operativelycoupled to an external device for processing data and generating imagesof a location within the patient body. Lens 42 is configured to generatedata signals representative of images at the location within the patientbody and transmit the data signals to the external device. In exampleembodiments, scope 40 is configured to be received within a trocarassembly. More specifically, scope 40 is movably positionable within anaccess channel formed in a cannula of the trocar assembly. The cannulahas a proximal portion and an opposing distal portion. The distalportion of the cannula is configured to extend into a patient body toassist with performing minimally-invasive surgical procedures including,for example, laparoscopic surgical procedures. The inner wall of thecannula forms or defines at least a portion of the access channel, whichextends between a first or proximal opening at the proximal portion ofthe cannula and an opposing second or distal opening at the distalportion of the cannula. The access channel is configured to receivescope 40 such that scope 40 can be maneuvered through the access channelto a location within the patient body.

Referring further to FIGS. 1 and 2, scope 40 includes a cylindricalhousing 44 having a proximal portion (not shown in FIGS. 1 and 2) and anopposing distal portion 46 with a distal end 48. In example embodiments,lens 42 is located at distal end 48 and, in certain embodiments, atleast partially set in housing 44. An integrated cleaning element 50 isoperatively coupled to distal portion 46 of housing 44. In certainexample embodiments, cleaning element 50 is movable between a firstposition and a second position contacting at least a portion of distalportion 46, e.g., lens 42, to remove condensation and/or debris, such asbodily fluids or displaced tissue, from distal portion 46, e.g., lens42, during a procedure. FIG. 1 shows distal portion 46 of scope 40 withcleaning element 50 in a first position and FIG. 2 shows distal portion46 of scope 40 with cleaning element 50 in a second position. In thefirst position, cleaning element 50 allows lens 42 to capture images ofthe location in the patient body and, in certain embodiments, extenddistally from distal end 48 of housing 44 at the location.

As shown in FIGS. 1 and 2, in this embodiment, cleaning element 50 isslidably coupled to a side wall 52 of housing 44 at distal portion 46.In a particular embodiment, cleaning element 50 is slidably positionedwithin a slot 54 formed in an outer surface 56 of housing 44. Cleaningelement 50 is movable between a first position, as shown in FIG. 1,toward a second position, as shown in FIG. 2, substantially contactingan outer surface of lens 42. As cleaning element 50 is moved between thefirst position and the second position, cleaning element 50 isconfigured to contact and move across lens 42. Cleaning element 50 ismade of or includes a suitable cleaning material to facilitate cleaninglens 42 to remove condensation and/or debris, such as bodily fluids ordisplaced tissue, from lens 42 and/or other portions of scope 40.Because cleaning element 50 is made of a suitable compliant, flexible orbendable material, such as a suitable shape memory material, cleaningelement 50 follows a contour of slot 54 and housing 44 as cleaningelement 50 moves between the first position and the second position.

Referring now to FIGS. 3-6, in another example embodiment, scope 40includes cleaning element 50 having a cover 60 that is rotatably coupledto distal portion 46 of housing 44 at or near distal end 48. FIG. 3shows distal portion 46 of scope 40 before cover 60 is cleaned usingcleaning element 50. FIG. 4 shows distal portion 46 of scope 40 ascleaning element 50 moves across cover 60 to clean cover 60. FIG. 5shows distal portion 46 of scope 40 after cover 60 is cleaned usingcleaning element 50. FIG. 6 shows distal end 48 of scope 40 as cover 60is cleaned using cleaning element 50. In this embodiment, cover 60 isconfigured to substantially extend over or enclose lens 42. In aparticular embodiment, cover 60 has a dome shape as shown in FIGS. 3-6.A band 62 extends laterally across cover 60. In example embodiments,band 62 has a first end 64 coupled to distal portion 46 at a first point66 and a second end 68 opposite first end 64 coupled to distal portion46 at a second point 70 laterally opposing first point 66, as shown inFIG. 6, for example. Band 62 is configured to remain in contact withcover 60 as cover 60 rotates or revolves between the first position andthe second position. As cover 60 moves with respect to band 62, band 62contacts cover 60 with sufficient frictional force to removecondensation and/or debris from cover 60, as shown in FIGS. 3-5.

Referring now to FIGS. 7-13, in example embodiments, cleaning element 50of scope 40 includes a band 72 extending laterally across lens 42. Inthese example embodiments, band 72 has a first segment 74 (extendinglaterally across lens 42) with a suitable cleaning surface configured tocontact lens 42. Scope 40, e.g., lens 42, is rotatable with respect tohousing 44 such that first segment 74 contacts lens 42 with sufficientfrictional force to remove condensation and/or debris from lens 42.Scope 40 or lens 42 can be rotated manually by the user, mechanically,or electronically. FIG. 7 is a perspective view of distal portion 46 ofscope 40 including band 72 extending laterally across distal portion 46with cleaning element 50 in a second position. FIG. 8 is a sectionalview of a portion of distal portion 46 shown in FIG. 7 with band 72contacting an outer surface of lens 42. Once lens 42 is cleaned usingband 72, cleaning element 50, e.g., band 72, is movable to a firstposition to allow lens 42 to move distally with respect to distal end 48of housing 44, e.g., to extend distally from housing 44. As shown inFIG. 9, band 72 is movable to a first position after cleaning of lens 42with band 72. Further, after first segment 74 of band 72 is used toclean lens 42, band 72 is advanced through housing 44 such that asterile second segment 76 adjacent used first segment 74 of band 72 ispositioned to contact lens 42 with cleaning element 50 in the secondposition, as shown in FIG. 10.

Referring further to FIG. 10, in example embodiments, housing 44includes a first passage 78 on a first lateral side of housing 44configured to accommodate band 72. During advancement, band 72 is fedthrough first passage 78, laterally across lens 42, and into a secondpassage 80 on a second lateral side of housing 44 opposite the firstlateral side of housing 44. As band 72 is advanced in a lateraldirection, used first segment 74 enters second passage 80 as sterilesecond segment 76 exits first passage 78 to extend over an opening 82formed by housing 44 in which lens 42 is positioned.

Similarly, in an example embodiment shown in FIGS. 11-13, cleaningelement 50 includes a band 84 extending laterally across lens 42. Inthis example embodiment, band 84 is made of a different material and/orhas different dimensions, e.g., diameter or circumference, from band 72shown in FIGS. 7-10, while operating similarly to band 72. For example,band 84 may include a plurality of outwardly-extending fibers 85. FIG.11 is a perspective view of distal portion 46 of scope 40 including band84 extending laterally across distal portion 46 with cleaning element 50in a second position. Once lens 42 is cleaned using band 84, cleaningelement 50, e.g., band 84, is movable to a first position to allow lens42 to extend distally from housing 44. FIG. 12 shows distal portion 46of scope 40 with band 84 in the first position after cleaning lens 42with band 84. Further, after a first segment 86 of band 84 is used toclean lens 42, band 84 is advanced through housing 44 such that asterile second segment 88 adjacent used first segment 86 of band 84 ispositioned to contact lens 42 with cleaning element 50 in the secondposition, as shown in FIG. 13.

In another example embodiment as shown in FIGS. 14-17, cleaning element50 of scope 40 includes an insert 90 configured to be removablypositioned within an access channel 92 at a distal portion of a trocarassembly 94. Insert 90 forms a central opening 96 for receiving scope40, allowing scope 40 to move through central opening 96. Insert 90includes a first passage, such as a first slit 98, formed through awidth of insert 90 (along a longitudinal direction of scope 40) on afirst lateral side 100 of central opening 96 and a second passage, suchas a second slit 102, formed through the width of insert 90 on a secondlateral side 104 of central opening 96 opposite first lateral side 100.A film 106 is movably positioned within first slit 98 and second slit102. In example embodiments, film 106 extends through first slit 98 in adistal direction, across central opening 96, and through second slit 102in a proximal direction. Film 106 has a first segment 108, such as acleaning pad, sponge, or other suitable material, including a cleaningsurface 110 configured to contact lens 42, as shown in FIGS. 14 and 15.With cleaning element 50 in a second position, first segment 108 ispositioned over central opening 96 such that cleaning surface 110contacts lens 42. Lens 42 is rotatable with respect to housing 44 suchthat cleaning surface 110 contacts lens 42 with sufficient frictionalforce to remove condensation and/or debris from lens 42.

Film 106 also includes a second segment 112 adjacent first segment 108.Second segment 112 forms an opening 114 that is aligned with centralopening 96 with cleaning element 50 in a first position to allow lens 42to extend through central opening 96 and co-axially aligned opening 114,as show in FIG. 17, such that lens 42 extends distally from distal end48 of housing 44. In this embodiment, after first segment 108 of film106 is used to clean lens 42, film 106 is advanced through housing 44such that second segment 112 adjacent first segment 108 is positionedover central opening 96 with opening 114 co-axially aligned with centralopening 96. As described above, housing 44 includes first slit 98 formedthrough a width of insert 90 on first lateral side 100 of centralopening 96 and second slit 102 formed through a width of insert 90 onsecond lateral side 104 of central opening 96 configured to accommodatefilm 106. During advancement, film 106 is fed through first slit 98,laterally across central opening 96, and into second slit 102. As film106 is advanced in a lateral direction, used first segment 108 enterssecond slit 102 as second segment 112 exits first slit 98 to extend overcentral opening 96 in which lens 42 is positioned.

Referring to FIGS. 18-20, in another example embodiment, cleaningelement 50 of scope 40 includes a first passage, such as a first slit116, formed through housing 44 on a first lateral side 118 of lens 42and a second passage, such as a second slit 120, formed through housing44 on a second lateral side 122 of lens 42 opposite first lateral side118. A film 124 is movably positioned within first slit 116 and secondslit 120. In example embodiments, film 124 extends through first slit116 in a distal direction, across lens 42, and through second slit 120in a proximal direction. Film 124 has a first segment 126, such as acleaning pad, sponge, or other suitable material, including a cleaningsurface 128 configured to contact lens 42. With cleaning element 50 in asecond position, first segment 126 is positioned over lens 42 such thatcleaning surface 128 contacts lens 42. Lens 42 is rotatable with respectto housing 44 such that cleaning surface 128 contacts lens 42 withsufficient frictional force to remove condensation and/or debris fromlens 42.

Film 124 also includes a transparent second segment 130 adjacent firstsegment 126. Second segment 130 is positioned over lens 42 with cleaningelement 50 in a first position. In this embodiment, after first segment126 of film 124 is used to clean lens 42, film 124 is advanced throughhousing 44 such that second segment 130 adjacent first segment 126 ispositioned over lens 42. As described above, housing 44 includes firstslit 116 formed through housing 44 on first lateral side 118 of lens 42and second slit 120 formed through housing 44 on second lateral side 122of lens 42 configured to accommodate film 124. During advancement, film124 is fed through first slit 116, laterally across lens 42, and intosecond slit 120. As film 124 is advanced in a lateral direction, usedfirst segment 126 enters second slit 120 as second segment 130 exitsfirst slit 116 to extend over lens 42.

In an example embodiment as shown in FIG. 21, cleaning element 50includes a film 132 operatively coupled to housing 44 at distal end 48.Film 132 extends between a first lateral side 134 of housing 44 and anopposing second lateral side 136 of housing 44 and contacts lens 42 withcleaning element 50 in a second position. With cleaning element 50 in afirst position, film 132 is configured in a retracted state (not shownin FIG. 21) on first lateral side 134 or second lateral side 136 ofhousing 44 to allow lens 42 to move distally with respect to distal end48 of housing 44. In this embodiment, film 132 is operatively coupled tohousing 44 at distal end 46.

Referring now to FIGS. 22-25, in example embodiments, scope 40 includescleaning element 50 having an expandable pad 140 initially positionedwithin an opening 142 formed by housing 44 to at least partially occludeopening 142 with cleaning element 50 in a second position. Expandablepad 140 is displaceable by scope 42. FIG. 22 shows distal portion 46 ofscope 40 with expandable pad 140 positioned in opening 142 and cleaningelement 50 in the second position. FIGS. 23 and 24 show distal portion46 of scope 40 shown in FIG. 22 as cleaning element 50 moves from thesecond position to a first position. FIG. 25 shows distal portion 46 ofscope 40 with expandable pad 140 displaced by scope 42 and cleaningelement 50 in a first position, allowing scope 42 to move throughopening 142 to extend distally with respect to housing 44. Expandablepad 140 has a suitable cleaning surface configured to contact scope 40to facilitate cleaning lens 42.

A central opening 144, e.g., a slit, is formed through expandable pad140 such that when lens 42 contacts expandable pad 140 with sufficientforce, lens 42 passes through central opening 144 to extend distallyfrom housing 44 as shown in FIG. 25. As lens 42 passes through centralopening 144, expandable pad 140 removes condensation and/or debris fromlens 42. Expandable pad 140 is moveable in a radially outward directionwith lens 42 extending into central opening 144. In this embodiment,expandable pad 140 is made of a suitable resilient material such thatexpandable pad 140 returns to an initial position substantially coveringopening 142 when scope 40 is retracted proximally into housing 44 andcleaning element 50 is in the second position.

Referring to FIG. 26, in another example embodiment, cleaning element 50of scope 40 includes a handle 150 at a proximal portion 152 of scope 40.An arm 154 is coupled to handle 150 and extends along a length of scope40 between proximal portion 152 and distal portion 46 of scope 40. Oneor more blades 156, e.g., a plurality of blades 156, are rotatablycoupled to arm 154 at distal end 46 of scope 40. Blades 156 areconfigured to rotate about a longitudinal axis 158 of arm 154 parallelto a longitudinal axis of scope 40. As blades 156 rotate aboutlongitudinal axis 158 with respect to arm 154, each blade 156 contactslens 42 to remove condensation and/or debris from lens 42.

As shown in FIGS. 27-29, in another example embodiment, cleaning element50 of scope 40 includes a protective shield 160 coupled to distalportion 46 of scope 40. Shield 160 extends distally with respect todistal end 48 of scope 40. In a particular embodiment, shield 160includes a retractable cone 162. With cleaning element 50 in a firstposition, shield 160 expands radially outward from distal end 48 so asto not obstruct the field of view of lens 42 while preventing orlimiting an amount of condensation and/or debris forming on lens 42during the procedure. With cleaning element 50 in a second position,shield 160 is retractable to cover or enclose lens 42. FIG. 27 showsdistal portion 46 of scope 40 including shield 160 in the secondposition, while FIGS. 28 and 29 show distal portion 46 of scope 40 withshield 160 in the first position.

In another example embodiment as shown in FIG. 30, cleaning element 50of scope 40 includes a dispenser 164 configured to express a fluid,e.g., a gas or a liquid such as a saline solution, through an annularspace 166 defined between housing 44 and lens 42.

In example embodiment as described herein, a trocar assembly includes acannula having a proximal portion and an opposing distal portion. Thedistal portion of the cannula is configured to extend into a patientbody. The cannula defines an access channel between the proximal portionand the distal portion, wherein the access channel is configured toreceive a scope such that the scope can be maneuvered through the accesschannel to a location within the patient body. The scope is movablypositioned within the access channel. A cleaning element operativelycoupled to a distal portion of the scope, e.g., integrally coupled tothe distal portion of the scope, is configured to contact at least alens of the scope to remove condensation and/or debris from the lensand/or other portions of the scope during the procedure.

In example embodiments as described herein, a method for cleaning adistal end of a scope, e.g., a lens of the scope, includes coupling acleaning element at a distal portion of the scope. The distal portion isconfigured to extend into a patient body to a location within thepatient body. At least a distal end of the scope, e.g., the lens, iscleaned with the cleaning element by moving the cleaning element withrespect to the distal end of the scope.

In example embodiments, cleaning element 50 includes one or moresurfaces configured to contact the distal end of scope 40 with cleaningelement 50 in a second position. Further, in certain embodiments,cleaning element 50 is movable between a first position and a secondposition via contact of cleaning element 50 with scope 40 or lens 42. Incertain example embodiments, cleaning element 50 may include one or moremembers, e.g., a plurality of members, configured to clean lens 42 uponcontact with lens 42. Suitable members include, without limitation, oneor more, e.g., a plurality of, brushes, bristles, fibers, fingers,leaflets, wipers, bands, pads, projections, or any combination thereof.In certain example embodiments, each member is made or formed of asuitable flexible or compliant material to allow each member to moveupon contacting scope 42 to allow scope 42 to freely move with respectto housing 44 as controlled by the user, e.g., the surgeon. While eachmember may be flexible or compliant, each member has sufficientresilience or rigidity to properly clean lens 42 as well as otherportions of scope 10.

As described herein, example trocar assemblies for use during alaparoscopic procedure include a cannula having a distal end forplacement into a patient body during the laparoscopic procedure. Thedistal end of the cannula may include a beveled or sharpened end tofacilitate entry of the cannula into the patient body. An obturator mayadditionally or alternatively be included. The cannula may includecertain surface characteristics, such as threads or ridges, to enhancethe stability of the trocar assembly when inserted into a body incision.

The cannula may include or may be in fluid communication with a chamberdefined by a proximal portion of the trocar assembly. The chamber mayhave a proximal opening configured to receive medical devices usedduring laparoscopic surgery, including, without limitation, graspers,dissectors, needles, scissors, clamps, electrodes, forceps, a camera,and/or a laparoscope (a “scope”). A valve may be located in the proximalopening and may form a seal or fluid barrier between the chamber and anexternal environment (e.g., the ambient room environment). Alternativelyor in addition, the valve may be located in another location (such as ata distal opening of the cannula). It may be advantageous for at leastone valve to be located at a the proximal opening such that a lens of ascope does not have to pass through the valve prior to cleaning, therebyreducing or eliminating the chance of materials from the valve dirtyingthe scope's lens after cleaning.

The chamber may be subjected to a continuous sterile and pressurizedenvironment that extends through the cannula and to the body cavity(herein referred to as the “internal environment” even though thecontinuous region may extend external of the patient body wall, e.g.,within the trocar assembly). This may be advantageous if maintaininginsufflation of the body cavity is desired during alloperation—including cleaning—of a trans-trocar-located scope or otherdevice. Further, the controlled environment of the chamber may reducefogging of a scope by eliminating or reducing temperature changes and/orchanges in humidity.

The valve (which may include more than one valve) may include aparticular structure that allows certain medical devices to pass throughthe proximal opening and into the chamber while maintaining the seal orfluid barrier. For example, the valve may include a duckbill seal, anannular seal structure, or both, but other suitable structures mayadditionally or alternatively be included. The valve may be formed witha compliant material such that it expands or contracts as necessary forcompatibility with scopes of different sizes. For example, on the ShoreHardness Scale, the valve may be formed of a material with a hardnessbetween about Shore A 20 to about Shore A 80, such as from about Shore A30 to about Shore A 60.

An insufflation inlet may communicate with the chamber and may beconfigured to control the pressure and other characteristics (e.g.,temperature, composition of the atmosphere), which may be advantageousfor providing precise control of insufflation of a body cavity duringthe laparoscopic procedure. The insufflation inlet may include aninsufflation valve, and may be in fluid communication with a pump orother suitable pressure source. Advantageously, the flow of gasses orother contents received into the chamber through the insufflation inletmay be introduced in a manner such that the effect of the flow acrosscleaning element is reduced or eliminated. For example, when thecleaning element (which is described in detail above) is wetted with acleaning fluid, concerns of increased evaporation due to fluid flow overthe cleaning element may be alleviated.

The trocar assembly may provide an entry or point of access into thebody for a scope. In non-limiting embodiments, the scope may include acommercially-available rigid laparoscope with a 5 millimeter (mm) or a10 mm diameter (or any other suitable diameter) with either a non-angledlens or an angled lens, which may be angled at 30 degrees, 45 degrees,or 50 degrees, for example, with respect to the longitudinal axis of thescope. At least a distal end of the scope may include one or moreelements designed to magnify, reflect, illuminate, and/or capture imagesof internal body areas under treatment, and then transmit those imagesback to the medical professional controlling the procedure (hereinreferred to as a “viewing element”). The scope may be inserted into theproximal opening of the chamber, may extend through the chamber, and mayextend through into the cannula through a distal opening in the bottomwall of the chamber, where the distal opening is in fluid and mechanicalcommunication with the cannula. The scope may further extend distally tothe distal end of the cannula and into the body cavity. In someembodiments, a sleeve (not shown, but readily understood as a lininglayer) may be located within the cannula, and the scope may pass throughthe sleeve. Once deployed, the scope may be manipulated by the medicalprofessional moving it distally/proximally, angling it, and/or byrotating it into a particular orientation. Typically, duringlaparoscopic procedures, scopes can become obstructed when debris (e.g.,condensation, displaced tissue, bodily fluids) are encountered andaccumulate on a lens of the scope, which may compromise the image orvideo feed provided to the medical professional.

The surface of the cleaning element may facilitate removal ofobstructions from the scope without necessitating removal of the scopefrom the internal environment. Advantageously, lengthy interruptions(and therefore increased surgical and anesthesia time) due to removingand/or replacing an obstructed scope may be reduced or eliminated.Further, the distal end of the scope may remain in the sterile internalenvironment during cleaning, which may advantageously alleviate concernsrelated to loss of sterility within the internal environment due to theremoval and re-entry of the scope one or more times for cleaningpurposes. Keeping the scope within the internal environment may alsoreduce or eliminate debris in the form of fogging or condensation causedby exposure to pressure and/or temperature changes when switchingbetween environments. It should also be understood that certainadvantages of the present embodiments are generally described asrelating to a scope for explanation purposes and may also extend toother types of instruments used during surgical procedures, andtherefore “scope” should be understood as including any suitable medicaldevice used during laparoscopic surgery when described in the context ofthe present embodiments, unless clearly excluded.

The cleaning element may incorporate any suitable structures, materials,and/or cleaning solutions for removing obstructions from the scope. Thecleaning element may have a unitary construction, or alternatively mayhave multiple surfaces or layers with different cleaning characteristicsor properties for facilitating multiple treatments. For example, it iscontemplated that the cleaning element may have a first region with anabrasive surface for breaking up potential obstructions, a second regionincluding a liquid, a gel, or other material for dissolving or washingaway the obstructions, and a third region with an absorbent or adsorbentsurface for removing any remaining residue.

The cleaning element may include any suitable cleaning structures ormaterials, such as sponges, foams (e.g., reticulated or non-reticulatedfoamed plastic polymers forming open-cell, semi-open cell, orclosed-cell foam structures), fibrous materials (e.g., materials withnatural (e.g., cellulosic) and/or synthetic fibers), microfiber or wipematerials (e.g., polyethers, polyamides, polyesters, and/or blends ofeach in a woven or non-woven construction with split or non-splitfibers), hydrophilic or hydrophobic materials, fluids, gases, bristles,films, etc. The structures and/or materials of the cleaning element mayinclude hydrophobic properties to assist in absorbing and wicking ofvarious bodily fluids and/or lipophilic characteristics for increasedabsorption of oils or fats. The cleaning element may be capable ofabsorbing at least 5 times its original weight of fluids, such as about15 times its original weight (or more). When the cleaning elementincludes pores, consistent or variable pore sizes may be consistently orrandomly dispersed (or layered) in certain configurations for suitableabsorption properties (for example, a the cleaning element may include amicro-porous foam with about 4 pores per inch to about 100 pores perinch). The cleaning element may have a firmness/compliance of about 2lbs/50 in² to about 80 lbs/50 in², and preferably about 6 lbs/50 in² toabout 45 lbs/50 in² (when tested at 25% deflection on a 20 inch by 20inch by 4 inch specimen). The material(s) of the cleaning element may beformed of a material suitable for use in a medical device (e.g., withsuitable biocompatibility, non-linting/no particulate, tear resistance,sterilization or other chemical/solvent compatibility, and radiationstability).

The cleaning element may be multi-layered in some embodiments. Forexample, a first layer may be configured to absorb a fluid obstructionlocated on the scope, and a second layer may be configured to retain ordiscard that fluid. In some embodiments, the first layer may include anopen-cell foam with relatively low density (such as polyurethane orsilicone foam) that may be used to effectively and quickly absorb (orwick, etc.) the obstructing fluid, and the second layer may includehigher-density foam for effectively retaining the fluid. The secondlayer may be located beneath (e.g., covered by) the first layer, forexample. Fibrous materials such as terrycloth and microfiber cloths mayadditionally or alternatively be used and may be advantageous forproviding a streak-free lens surface when wiped against the scope. Thesolid materials of the cleaning element may be combined or “wetted” witha cleaning fluid, such as an anti-fog fluid, sterile water, saline, or adetergent, for example, which may facilitate the removal of fattysmudges and dried-on debris.

In the event the medical professional's visibility becomes compromiseddue to obstruction of the scope during surgery, the distal end (or otherlocation) of the scope may then be wiped or swept by pressing and/orrubbing the distal end of the scope on the cleaning element to removeobstructions. As explained above, this cleaning procedure mayadvantageously be completed without removing the scope from the internalenvironment in the trocar assembly. In certain embodiments, the cannulamay be formed of a transparent or translucent material. When the scopeis located in the trocar assembly, the scope (which often includes alight) may illuminate the cannula to increase visibility.

In some embodiments, the cleaning element may be selectable, removable,and/or replaceable. Thus, the trocar assembly may be capable of allowingaccess into the chamber (e.g., in an operating room prior to a surgery)such that a medical professional can select an appropriate version ofthe cleaning element and then use that cleaning element with the trocarassembly during the procedure. The cleaning element may additionally oralternatively be replaced during a medical procedure (e.g., if itbecomes soiled), and/or may be replaced between medical proceduresduring reprocessing of the trocar assembly if the trocar assembly isreusable.

Those of skill in the art will appreciate that existing scopes andpotential scope designs include at least one non-longitudinal,distal-end-facing surface of the distal end that may be generally orexactly perpendicular to the longitudinal axis of the scope, or whichdistal-facing surface may be configured at a non-perpendicular anglerelative to the longitudinal axis (e.g., 30 degrees off-perpendicular,45 degrees off-perpendicular). It is further contemplated that thedistal-facing surface of the scope may be flat/planar, concave, orconvex relative to the major plane of that face. The term“non-longitudinal, distal-end-facing surface” is meant to include theoperative end face(s) of a scope in distinction from the longitudinallateral sides of the scope, which will generally be columnar orcylindrical. Thus, as described in more detail below, the surfacecharacteristics of the cleaning element may be shaped or otherwiseconfigured for compatibility with a variety of distal-facing surfaces ofthe scope.

Those of skill in the art will appreciate that embodiments not expresslyillustrated herein may be practiced within the scope of the claims,including that features described herein for different embodiments maybe combined with each other and/or with currently-known orfuture-developed technologies while remaining within the scope of theclaims. This specifically includes that the structure, location, andmechanisms of the disclosed cleaning elements and related structures inthe different embodiments illustrated and described with reference tothe drawing figures may be combined and elements interchanged within thelevel of skill in the art as informed by this application, and withinthe scope of the present claims, which includes that a variety ofdisclosed individual cleaning element components dimensioned for useencompassed within in laparoscopy trocars may be configured asseparable/replaceable components of a larger trocar assembly. Althoughspecific terms are employed herein, they are used in a generic anddescriptive sense only and not for purposes of limitation unlessspecifically defined by context, usage, or other explicit designation.It is therefore intended that the foregoing detailed description beregarded as illustrative rather than limiting. And, it should beunderstood that the following claims, including all equivalents, areintended to define the spirit and scope of this invention. Furthermore,the advantages described above are not necessarily the only advantagesof the invention, and it is not necessarily expected that all of thedescribed advantages will be achieved with every embodiment. In theevent of any inconsistent disclosure or definition from the presentapplication conflicting with any document incorporated by reference, thedisclosure or definition herein shall be deemed to prevail.

We claim:
 1. A scope, comprising: a housing having a distal portion witha distal end; a lens at the distal end; and a cleaning elementoperatively coupled to the distal portion of the housing, wherein thecleaning element is movable between a first position and a secondposition contacting the distal end.
 2. The scope of claim 1, wherein thecleaning element is slidably coupled to a side wall of the housing atthe distal portion, and as the cleaning element is moved toward thefirst position, the cleaning element is configured to move across thelens.
 3. The scope of claim 2, wherein the cleaning element is made of ashape memory material.
 4. The scope of claim 1, wherein the cleaningelement further comprises: a cover rotatably coupled to the distalportion of the housing at the distal end, the cover extending over thelens; and a band extending laterally across the cover, wherein the bandis configured to remain in contact with the cover as the cover revolvesbetween the first position and the second position.
 5. The scope ofclaim 4, wherein the band has a first end coupled to the distal portionat a first point and a second end opposite the first end coupled to thedistal portion at a second point laterally opposing the first point. 6.The scope of claim 1, wherein the cleaning element comprises a bandextending laterally across the lens, the band having a first segmentwith a cleaning surface configured to contact the lens as the lens isrotatable with respect to the housing.
 7. The scope of claim 6, whereinthe band is movable from the second position to the first position toallow the lens to move distally with respect to the distal end of thehousing.
 8. The scope of claim 6, wherein the band is configured toadvance in a lateral direction such that a second segment adjacent thefirst segment contacts the lens.
 9. The scope of claim 1, wherein thecleaning element further comprises: an insert configured to be removablypositioned within an access channel at a distal portion of a trocarassembly, the insert forming a central opening for receiving the scopeand comprising a first slit formed through a width of the insert on afirst lateral side of the central opening and a second slit formedthrough the width of the insert on a second lateral side of the centralopening opposite the first lateral side; and a film movably positionedwithin the first slit and the second slit, the film extending throughthe first slit in a distal direction, across the central opening, andthrough the second slit in a proximal direction, the film having a firstsegment including a cleaning surface configured to contact the lens. 10.The scope of claim 9, wherein the film further comprises a secondsegment adjacent the first segment, the second segment forming anopening aligned with the central opening to allow the lens to extendthrough the central opening and the opening.
 11. The scope of claim 10,wherein the film is movable to position one of the first segment and thesecond segment over the central opening.
 12. The scope of claim 9,wherein the film further comprises a transparent second segment adjacentthe first segment.
 13. The scope of claim 1, wherein the cleaningelement comprises a film operatively coupled to the housing at thedistal end, wherein the film extends between a first lateral side of thehousing and an opposing second lateral side of the housing and contactsthe lens with the cleaning element in the second position, and, with thecleaning element in the first position, the film is configured in aretracted state on the first lateral side of the housing.
 14. The scopeof claim 1, wherein the cleaning element comprises an expandable padpositioned within an opening formed by the housing, with the cleaningelement in the second position, the expandable pad occludes the opening,the expandable pad including a central opening formed through theexpandable pad, the expandable pad moveable in a radially outwarddirection with the lens extending into the central opening.
 15. Thescope of claim 1, wherein the cleaning element comprises: a handle at aproximal portion of the scope; an arm coupled to the handle andextending along a length of scope between the proximal portion and thedistal portion; and a plurality of blades rotatably coupled to the armat the distal end of the scope, the plurality of blades configured tocontact the lens during rotation of the plurality of blades with respectto the arm.
 16. The scope of claim 1, further comprising a shieldcoupled to the distal portion of the scope, the shield extendingdistally with respect to the distal end of the scope.
 17. The scope ofclaim 16, wherein the shield comprises a retractable cone, wherein inthe first position the shield expands radially outward from the distalend and in the second position the shield covers the lens.
 18. The scopeof claim 1, wherein the cleaning element further comprises a dispenserconfigured to express a fluid through an annular space defined betweenthe housing and the lens.
 19. A trocar assembly, comprising: a cannulahaving a proximal portion and an opposing distal portion, the distalportion configured to extend into a patient body, the cannula definingan access channel between the proximal portion and the distal portion; ascope movably positioned within the access channel, wherein the scopecan be maneuvered through the access channel to a location within thepatient body; and a cleaning element operatively coupled to a distalportion of the scope, wherein the cleaning element is configured tocontact at least a lens of the scope.
 20. A method for cleaning a distalend of a scope, said method comprising: coupling a cleaning element at adistal portion of the scope, the distal portion configured to extendinto a patient body to a location within the patient body; and cleaningat least a distal end of the scope with the cleaning element by movingthe cleaning element with respect to the distal end of the scope.